Ending preventable stillbirths: introducing a scorecard to measure progress against global targets

Ending preventable stillbirths: introducing a scorecard to measure progress against global targets

Susannah Hopkins Leisher (1), Patricia Doherty (2), Sara Nam (2), Hannah Blencowe (3), Paula Quigley (4)

(1) International Stillbirth Alliance, Mater Research Institute (University of Queensland), Columbia University; (2) Evidence for Action – MamaYe! Options Consultancy Services Ltd. UK (3) London School of Hygiene & Tropical Medicine; (4) DAI Global Health (paula_quigley@dai.com)
On behalf of the Stillbirth Advocacy Working Group

Introduction
Each year an estimated 2.6 million babies are stillborn. Progress to reduce this large burden has been slow. The Lancet’s 2016 Ending Preventable Stillbirths series’ Call to Action summarized what is required to end preventable stillbirths and ensure quality post-bereavement care, but as yet there is no regular tracking of progress. We developed a Global Scorecard to fill this gap. The Scorecard measures progress against the Call to Action’s three components: 2030 mortality targets, universal health care coverage (UHC) targets, and global and national milestones for improving care and outcomes for all mothers and babies (as specified by the Every Newborn Action Plan, ENAP), including those affected by stillbirth.

Description
For each target, we aimed to identify at least one indicator currently being tracked at the global level; the current Scorecard includes 17 indicators and is populated with the most up-to-date global data:
• Mortality: 31% of high-burden countries have set national stillbirth targets; no tracking of sub-national stillbirth rates.
• UHC: global standards set for antepartum and intrapartum care, but no tracking of quality, essential for stillbirth prevention.
• Milestones: ENAP milestones being tracked; work begun on global consensus on bereavement care, but no tracking of national bereavement care or stigma reduction.

Summary
Existing monitoring mechanisms are inadequate to monitor progress against the Call to Action. Next steps include further refinement of the Scorecard with key stakeholders and creation of country-specific and high-income region versions. Despite shortcomings of existing data, the Scorecard suggests some progress is being made, but improvements in funding and accountability mechanisms are needed to achieve the goal of ending preventable stillbirths.

Ethics
Ethics approval was not deemed necessary for this work.

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